Why is the C-section rate still climbing in Canada?
The number one reason for surgery in Canada is a Cesarean section delivery, according to the the latest data from the Canadian Institute for Health Information (CIHI).
Every year, the rate of delivering a baby via surgery continues to climb and is far above the ideal rate put forward by the World Health Organization. Last year, 28.8 per cent of births were performed by C-section, compared to 28.2 in 2016-2017, according to numbers from the CIHI.
In 2007-2008, 26.7 per cent of Canadian births were via C-section and in 2000, the rate was 21.4 per cent.
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The biggest contributing factor for the increase in C-sections is repeat C-sections, according to Dr. Sarah Munro, a postdoctoral fellow at the University of British Columbia and a researcher with the Centre for Health Evaluation and Outcome Sciences.
“So that’s where a person has a Cesarean for their first birth and then has a repeat Cesarean for their second or third births or so on,” Munro said.
Munro said until the mid 1990s, there was a trend for planning for Vaginal Births After Cesarean, also known as VBACs.
“It was much more common and it was supported in the health care system. But then there was a change in culture that really swung the pendulum in the other direction to a trend towards repeat C-sections,” Munro said.
“It’s totally possible for the vast majority of women to attempt a VBAC.”
Watch below (Oct. 13, 2018): Global increase in C-section births
Munro would like to see more health professional present the option of a VBAC early.
“Planting the seed early on that a vaginal birth after Cesarean is a great way to start tackling the Cesarean section rate,” she said.
“This can be done within the first six weeks of having a Cesarean.”
The World Health Organization considers a C-section rate of between 10 and 15 per cent to be ideal, saying, “when the rate goes above 10 per cent, there is no evidence that mortality rates improve.”
However, Dr. Ellen Giesbrecht, a medical advisor to Perinatal Services BC and OB-GYN at BC Women’s Hospital, said the WHO’s recommendation is unrealistic for Canada.
“I don’t think 15 per cent for a Cesarean section rate will ever be achievable in most developed countries,” Giesbrecht said.
More women in Canada have diabetes, high blood pressure and are older, which are all contributing factors to C-sections, she said.
Giesbrecht said the C-section rate in Canada should not be evaluated on its own, but needs to be looked at while considering downstream affects.
“With the slowly increasing (C-section) rate, are we also holding steady for improving baby outcomes? We actually don’t know because we haven’t looked at that in conjunction with the Cesarean section rate in a systematic way.”
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